Online Forms

Diegel Chiropractic Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • Download the necessary form(s), print and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Forms - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Please download and print the following forms.  Complete the forms and bring the completed forms with you to your appointment.

New Patient - Download & Print


Good Faith Estimate & Disclosure Form

Please fill out this form to bring to your first appointment.

The attached document will go over possible fees you may experience at our office. Just because a fee is listed does not always mean you will get charged for that service.

The below form is strictly to provide an estimate of fees for services provided. If you have any questions about the fees or your insurance coverage or lack thereof please call our office at 586-254-2060 and we will be happy to assist you.

Good Faith Estimate & Disclosure - Download & Print


Massage Client Information

Massage Client Information - Download & Print



Hours of Operation

Monday

9:00 am - 12:00 pm

2:00 pm - 6:00 pm

Tuesday

2:00 pm - 7:00 pm

Wednesday

9:00 am - 12:00 pm

2:00 pm - 6:00 pm

Thursday

Closed

Friday

9:00 am - 12:00 pm

2:00 pm - 6:00 pm

Saturday

Appointment Only

Sunday

Closed

Monday
9:00 am - 12:00 pm 2:00 pm - 6:00 pm
Tuesday
2:00 pm - 7:00 pm
Wednesday
9:00 am - 12:00 pm 2:00 pm - 6:00 pm
Thursday
Closed
Friday
9:00 am - 12:00 pm 2:00 pm - 6:00 pm
Saturday
Appointment Only
Sunday
Closed

Our Location

Contact Us

We look forward to hearing from you